How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,737.80 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,737.80 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $3,548.13 | Professional | None | $1,737.80 | $1,737.80 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $3,162.28 Typical High $16,218.10 | Facility | None | $1,122.02 | $3,162.28 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,398.83 Typical High $4,168.69 | Professional | None | $1,621.81 | $2,398.83 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,513.56 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,096.48 | $1,513.56 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $426.58 Typical High $707.95 | Professional | 80 · Assistant surgeon | $275.42 | $426.58 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $338.84 Typical High $602.56 | Professional | AS · PA/NP assist | $239.88 | $338.84 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,884.03 Typical High $5,248.07 | Professional | None | $1,995.26 | $2,884.03 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $4,570.88 | Professional | None | $1,737.80 | $2,187.76 | $4,570.88 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,370.32 | Professional | None | $1,698.24 | $2,511.89 | $5,370.32 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | 52 · Reduced service | $851.14 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | 53 · Discontinued | $346.74 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,412.54 |
Where Georgia sits
The same service costs 5.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Georgia· 18th of 51
$2,399
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.